title: The impact of total parenteral nutrition support on pregnancy outcome in women with hyperemesis gravidarum.
abstract: OBJECTIVE
  To assess pregnancy outcome among women with hyperemesis gravidarum (HEG) with and without total parenteral nutrition (TPN) support.
  
  
  METHODS
  A retrospective study of all pregnant women with singleton pregnancies who were hospitalized due to HEG between 1997 and 2011. Pregnancy outcome was compared with a control group without HEG matched by maternal age and parity in a 3:1 ratio.
  
  
  RESULTS
  Overall 599 women were admitted during the study period with the diagnosis of HEG and subsequently delivered in our center. Of those, 122 (20.4%) received TPN support. Women in the HEG group were characterized by a higher rate of severe preeclampsia (1.3% versus 0.5%, p = 0.04), and a higher rate of preterm delivery at less than 37 and 34 weeks (10.9% versus 6.9%, p < 0.001 and 4.7% versus 1.6%, p < 0.001, respectively). Neonates in the HEG group were characterized by a lower birth weight (3074 ± 456 g versus 3248 ± 543 g, p < 0.001), higher rate of birth weight < 10th percentile (12.7% versus 6.8%, p < 0.001), and a higher rate of neonatal morbidity (8.7% versus 3.8%, p < 0.001). These associations persisted after adjustment for potential confounders, and were of most notable among women with HEG who did not receive TPN support.
  
  
  CONCLUSIONS
  HEG is an independent risk factor for adverse pregnancy outcome. TPN support during early pregnancy is associated with a decreased risk for perinatal morbidity.
authors.affiliation: Department of Obstetrics and Gynecology, Helen Schneider Hospital for Women, Rabin Medical Center , Petach Tikva , Israel and.
authors.forename: Yoav
authors.initials: Y
authors.lastname: Peled
authors.forename: Nir
authors.initials: N
authors.lastname: Melamed
authors.forename: Liran
authors.initials: L
authors.lastname: Hiersch
authors.forename: Joseph
authors.initials: J
authors.lastname: Pardo
authors.forename: Arnon
authors.initials: A
authors.lastname: Wiznitzer
authors.forename: Yariv
authors.initials: Y
authors.lastname: Yogev
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D006939:Hyperemesis Gravidarum / Q000453:epidemiology* / Q000628:therapy*; D007231:Infant, Newborn; D008297:Male; D010289:Parenteral Nutrition, Total; D011225:Pre-Eclampsia / Q000453:epidemiology; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D047928:Premature Birth / Q000453:epidemiology; D055815:Young Adult
keywords: Hyperemesis gravidarum; pregnancy; total parenteral nutrition